Stability of skeletal class III surgical treatment. Affect of high condylectomy

Abstract

Purpose: To evaluate the role of high condylectomy on surgical treatment stability of Class III patients with condylar hyperplasia. Materials and Methods: Twenty-four patients (9 females and 15 males) were paired according to gender, age, skeletal and dental characteristics in three groups. Group 1 (no condylar hyperplasia) underwent orthognathic surgery only, Group 2 (with unilateral or bilateral condylar hyperplasia) underwent high condylectomy, articular disc repositioning and orthognathic surgery in the same procedure and Group 3 (with unilateral or bilateral condylar hyperplasia) underwent orthognathic surgery only. Lateral cephalometric radiographs were selected at the immediately before surgery (T1), immediate after surgery (T2) and longest follow-up (T3). Results: Cephalometric comparison between the 3 groups showed no significant differences among the variables at the initial observation period (T1). During the observational period (T3-T2), patients in Group 3 showed significant relapse at SNB (mean = 2.18, sd = 1.39 degrees), ANB (mean = -2.68, sd = 2.24 degrees), SN.Pog (mean = -1.48, sd = 1.66 degrees), OJ (mean = -2.99, sd = 1.64 mm), OB (mean = 1.45, sd = 1.16 mm), Ar-Go (mean = 2.23, sd = 2.66 mm), Ar-Gn (mean = 3.76, sd = 1.48 mm), S-Gn (mean = 2.3, sd = 2.34 mm) and ANS-Me (mean = 2.06, sd = 2.2 mm) demonstrating that treatment adopted was insufficient for stable results within this Group. Groups 1 and 2 remained stable one year after surgery. Conclusions: Orthognathic surgery for correction of skeletal class III malocclusion is a stable procedure for patients without condylar growth abnormalities and for patients undergoing simultaneous high condylectomies and articular disc repositioning. Those patients with preoperative condylar hyperplasia who underwent double-jaw surgery and no TMJ intervention experienced significant relapse.